Structural, functional, and symptom relations in painful distal symmetric polyneuropathies: a systematic review

Pain
Páll KarlssonSimon Haroutounian

Abstract

The diagnosis of distal symmetric polyneuropathies (DSPs) relies on the presenting symptomatology and neurological sensory examination, supported by objectively quantified structural and functional changes in sensory nerves. Although these separate components have important diagnostic utility, the associations between the structural vs the symptomatic and functional findings in painful DSP are still unclear. It is assumed that delineation of the correlations, or lack of such, between structure, clinical presentation, and function will contribute to a better understanding and treatment of DSP. This systematic review assessed small fiber morphology in patients with different types of painful DSP, and compared it with symptoms, signs, and nerve fiber function. Overall, 111 papers met the inclusion criteria for the systematic review. The results indicate that epidermal nerve fiber loss, in isolation, is not a useful indicator of painful symptoms or their severity in DSP. Intraepidermal nerve fiber density correlated reasonably well with neuropathy scores on tools assessing signs and symptoms (such as the Michigan Neuropathy Screening Instrument and the Total Neuropathy Score), but less so with symptom measures only. Among various p...Continue Reading

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Citations

May 14, 2020·Behavioural Neurology·Endre PálSámuel Komoly
Aug 6, 2019·Frontiers in Medicine·Martin Schmelz
Dec 9, 2020·Journal of Neural Engineering·Aida Hejlskov PoulsenCarsten Dahl Mørch
Mar 13, 2021·Brain : a Journal of Neurology·Troels S JensenBrian C Callaghan
Apr 24, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Isin Unal-CevikElmas Burcu Mamak-Ekinci
Oct 16, 2021·Lab Animal·Suzan MeijsWinnie Jensen
Jan 8, 2022·Journal of Neural Engineering·Aida Hejlskov PoulsenCarsten Dahl Mørch

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